Planned Parenthood Abortion Business Settles Medicaid Fraud Case

State   |   Steven Ertelt   |   Oct 30, 2010   |   6:03PM   |   Olympia, WA

The state of Washington and the Planned Parenthood of the Inland Northwest have agreed on a settlement in a Medicaid fraud case that saw the abortion business routinely overcharge the state government.

Initial audits from Washington state officials showed Planned Parenthood wrongly overbilled the state $629,143 over a three-year period, according to the Associated Press.

However, the abortion business appealed the case and, on Friday, announced a settlement whereby it would not admit any incorrect billing, documentation or payment and Planned Parenthood will only repay $345,000 of the money it obtained.

AP indicates the findings were based on 333 abortions done between March 2004 to February 2007, a period which saw Washington state provide Planned Parenthood more than $7.6 million from Medicaid for abortions and birth control.

David Schmidt of the pro-life group Life Action, which monitors Planned Parenthood, commented on the settlement, calling it a “dirty trick” that “paid off.”

Schmidt says “Planned Parenthood President Cecile Richards was with Washington’s pro-abortion Governor Christine Gregoire earlier this month” and noted a message posted on her Facebook account saying it was “great” to spend time with her.

“Did Cecile Richards meet with her pal Governor Christine Gregoire to hash out a deal where Planned Parenthood paid back some of their over-billing while not admitting to any wrongdoing and escaping fraud charges? We may never know for sure but we do not that Planned Parenthood’s operation is routinely protected by political allies,” he said.

The audit by sate officials found Planned Parenthood was routinely overbilling Medicaid for abortions as well as contraception and family planning services.

According to the audit, state health officials found Planned Parenthood of Spokane was “unbundling” abortion claims and falsely billing for doctor visits when customers were picking up prescriptions.

Mary Emanuel, who runs the web site Abortion in Washington, obtained copies of the audit documents from the Department of Social and Health Services.

“The audit did not get into the question of whether the overbilling was part of a systematic fraud scheme, but it also was clear that if this practice continued PPS would lose its Medicaid billing privileges,” she wrote last year.

The audit found five categories of overbilling, including “unbundling” post-abortion drugs and billing them to Medicaid as family planning, which is prohibited. The practice appears at odds with longstanding Planned Parenthood claims that family planning money doesn’t pay for abortions or abortion-related services.

Other cases included billings for pregnancy tests done on women who never said they thought they were pregnant and without any indication the tests were medically necessary.

They also included overbilling on fraudulent birth control prescriptions or for drugs sold without a prescription, billing for more than three times the cost of condoms, and billing office visits to pick up a prescription or get an injection.

Emanuel indicates the auditors “made a point that it didn’t claim to have been exhaustive…. The audit didn’t address the question of whether these practices were going on prior to 2004, or after 2007, including up to the present, or the question of whether it was systematic and intentional, thus rising to the level of fraud.”

At the time, Emanuel said Planned Parenthood must be concerned about future problems as officials hired attorneys and a Medicaid expert to defend itself.

The blog is also concerned about future Medicaid overbilling, or fraud, and whether other Planned Parenthood affiliates in Washington state are engaging in the practices.

“The audit itself also didn’t deal with the question of who is going to ensure that these overbillings are not going on right now,” it said.

“Some might argue that Medicaid billing is complicated and errors are inevitable. But no organization on earth should have more expertise in how to bill Medicaid correctly for contraceptives than Planned Parenthood,” the writers conclude.

The Washington state case of overbilling is not an isolated one as overbilling problems also extended to Planned Parenthood centers in New Jersey.

The U.S. Inspector General for the Department of Health and Human Services uncovered a consistent problem with New Jersey-based family planning clinics run by the Planned Parenthood abortion business. They were found to be improperly billing Medicaid for services that did not qualify as family planning.

New jersey authorities were sent letters in July 2007, June 2008 and August 2008 notifying them of the problems and requesting action to correct the errors. The reports found billing errors from February 1, 2001 through January 31, 2005.

An initial audit revealed New Jersey improperly received federal reimbursement at the enhanced 90% rate for 160,955 prescriptions drug claims that were billed as family planning, but did not qualify as family planning services. A letter from the Inspector General to New Jersey officials recommended that New Jersey repay $2,219,746 to the federal government.

The state eventually returned $2.9 million to the federal government last month.

In California, P. Victor Gonzalez, the former Chief Financial Officer for Planned Parenthood of Los Angeles saw millions in fraudulent overbilling to state and federal governments and was subsequently fired when he blew the whistle.

He filed a lawsuit that a lower court dismissed but a federal appeals court, in July, reinstated.

Gonzalez says his own internal audit estimates that Planned Parenthood overcharged California taxpayers for purchasing birth control by at least $180 million.

But a new Fox news report indicates he also found $5.2 million in overbilling at one Planned Parenthood affiliate in San Diego alone and he says Planned Parenthood officials intervened to prevent internal audits.

While other public health facilities and private facilities charged the state between $8 and $9 for a cycle of birth control pills, Planned Parenthood charged almost $12. The Planned Parenthood charge to the California government was several times more than it paid for the drugs originally.

In one case Fox News highlighted in its report, Planned Parenthood Los Angeles paid $225,695.65 for Ortho Tri-Cyclen birth control pills but billed the state government more than $918,000.

Though Planned Parenthood Affiliates of California dismisses the lawsuit and questions about it, the national Planned Parenthood abortion business is apparently more concerned.

The regional affiliate of Planned Parenthood where teenager Holly Patterson died from using the dangerous RU 486 abortion drug first lost its affiliation with Planned Parenthood in early August because of significant financial mismanagement.

Earlier in September, the New York Times released a new report showing Planned Parenthood Golden Gate faces an audit form the criminal division of the Internal Revenue Service.

The report detailed how an unnamed former employee interviewed with the Oakland field office of the IRS on Tuesday in response to a complaint he lodged with the governmental agency.The employee, who would not let the Times name him for fear of his future job prospects, said he filed a two-part complaint about the abortion businesses’ problematic relationship with its political arm and about financial problems at the abortion business,

Also, pro-life advocates say they believe Planned Parenthood in Iowa is overbilling the state and “bilking insurance companies out of grossly inflated fees.”

Operation Rescue revealed Planned Parenthood is charging insurance companies $1,000 for the drug-induced abortion process even though the overhead costs for the abortion is lower with the abortion practitioner off site via telemed abortions.

This overbilling effectively drives up the cost of health insurance for everyone, its president, Troy Newman, contends.

“Planned Parenthood of the Heartland is making a killing on medical abortions,” he said. “Planned Parenthood is gouging insurance companies twice the price of their cash abortions. That’s how they can afford to keep their smaller clinics running.”

“And if taxpayers are forced to fund these abortions, there’s no telling how much they will charge, because government funding is a blank check,” he added.